Presented by: Dor Rubinshtein MD
Urology department, Kaplan medical center

Introduction

Studies report an association between high ambient temperatures and urinary stone formation, as well as emergency room admissions for renal colic during warm months and periods of fasting. Data regarding stone characteristics under such conditions are scarce. We explored the difference in stone characteristics that were diagnosed during heat waves in comparison to periods with average temperatures.

Materials

We retrospectively collected data between 2018-2021, for patients who had a positive computer tomography finding of urinary stones. Patients diagnosed with urolithiasis during a two-week period starting from a heat wave were included in group 1. The remaining patients with urolithiasis who were diagnosed during two weeks prior to or following the heat wave period and having average monthly temperatures were included in group 2. Heat waves were defined as days with a temperature five degrees Celsius or higher than the multi-year monthly average, and lasting longer than 3 days. We collected demographic, clinical and radiographic data and compared the two groups.

Results

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Of 229 patients who met the inclusion criteria, group 1 (heat waves) included 121 patients and group 2 (average temperatures) included 108 patients. No statistical difference was found between the groups in term of age (51 vs. 52), gender (76% vs. 73% men), average number of stones (1.6 vs. 1.8) and ureter stone rates (72% vs. 66%), respectively. In group 1, 73% of patients (88 of 121) had stones under 5 mm, in comparison to 60% in group 2 (P=0.04). In a multivariate analysis, adjusting to duration of symptoms and stone location, heat waves were a risk factor for presence of stones under 5 mm (OR=1.8, P=0.04).

Conclusion

There is a higher probability of finding small urinary stones during heat waves, compared to periods with average temperatures. This finding may provide insight into the mechanism of stone formation and can assist the decision-making process in the ER.

Funding

none

Lead Authors

Noa Eliezer, MD
Kaplan medical center

Co-Authors

Dan haberman, MD
Heart institute, kaplan medical center

Roy Croock, MD
Urology department, Kaplan medical center

Brian Berkowitz, D.Sc
Weizmann Institute of Science

Ishai Dror, Ph.D
Weizmann Institute of Science

Shir Tiger, MD
Urology department, Kaplan medical center

Alexey Kovalyonok, MD
Urology department, Kaplan medical center

Dan Leibovici, MD
Urology department, Kaplan medical center

Yaniv Shilo, MD
Urology department, Kaplan medical center